| The purpose of this qualitative study was to explore the experiences of operating room nurses on how culture and politics drives their perceptions toward performance improvement in the operating room. Secondarily, do culture and politics circumvent success of performance improvement initiatives in the operating room? The study was performed in the operating room of a military hospital. The review of literature revealed that the perioperative nursing profession continues to struggle to cope with culture and politics while improving performance. Numerous researchers have validated that politics and behaviors embedded in the culture continue to be prevalent, and impacts nursing perceptions to effectively implement and sustain performance improvement. As focus remains on improvement performance and patient safety in operating rooms, any investigation that contributes to understanding culture and politics in the operating room should be rigorously pursued. This study examined a gap in knowledge taken from nursing's reflection of their experiences regarding the influence of culture and surgeon politics on sustaining performance improvement in the operating room. Since the operating room environment is dependent on the relationships between doctors and nurses, the social framework of constructivism was essential to understanding how the environment permits performance improvement to be achieved but not sustained. Constructivism guided the researcher to examine and understand a nurse's experiences and perspective on the influence of operating room culture and physician politics toward sustaining improvements in the operating room. Semi-structural interviews were performed and text analysis was done to identify common themes. The five themes identified are relationships between nurses and surgeons, surgeon and staff compliance, operating room staff clinical competency, competing priorities, and military influence in the operating room. Complexity and unpredictability of the operating room environment were clearly identified as factors affecting quality, safety and cost. This study provided new information in the findings that is not covered in existing literature; primarily around military influence on patient safety in the operating room. |
